Abstract: Objective To investigate the incidence of endometrial lesions and the value of endometrial cytology in endometrial carcinoma screening among rural menopause women in Baiyun District of Guangzhou City.Methods From May 2015 to October 2016, a prospective investigation was conducted on rural postmenopausal women in Baiyun District, Guangzhou. The gynecologist strictly filled in the Epidemiological Survey of Endometriosis in Postmenopausal Women. A cluster sampling method was used to extract the data of all patients with endometrial lesions. According to the symptoms and high risk factors of the women, the endometrial cytology sampling and liquid-based thin-layer cytology were combined to use. Then, according to the results of cytology, the pathological examination was used.Results Of the 129 women, 22 women had endometrial lesions and 19 women had high risk factors of endometrial cancer. In the endometrial cytology examination, 15 were endometrial lesions. Among them, 12 were consistent with the results of pathological examination. The accuracy, sensitivity and specificity of endometrial cytology for endometrial carcinoma were 86.67%, 75.00% and 88.89%, respectively. The endometrial thicknesses of patients with consistent results were larger than those with inconsistent results when follow-up in 3 months and in 6 months.Conclusion The incidence of endometrial disease in rural menopausal women in Baiyun District of Guangzhou City is more serious. Endometrial cytology is an effective method to screen endometrial carcinoma.